P1581: DYNAMICS OF NT-PROBNP LEVEL IN UNRELATED DONORS DURING MOBILIZATION OF HEMATOPOIETIC STEM CELLS
Authors: Natalia Minaeva, Natalia Zorina, Marina Khorobrikh, Philipp Sherstnev, Tatiana Krivokorytova, Alexander Luchinin, Maksim Minaev, Igor Paramonov
Journal: HemaSphere (2023)

Topic: 31. Transfusion medicine Background: Over the last few decades, National Marrow Donor Program (NMDP), Center for International Blood and Marrow Transplant Research (CIBMTR), World Marrow Donor Association (WMDA) have been actively working to ensure the safety of the hematopoietic stem cell (HSC) donation process. Registration of adverse events that may occur during the donation period, establishing a causal relationship between donation and side effects is a necessary part of WMDA accreditation. The level of blood serum N-terminal pro-brain natriuretic peptide (NT-proBNP) is an early marker of myocardial stress. Due to the high analytical sensitivity and specificity, laboratory assessment of NT-proBNP makes it possible to objectively diagnose myocardial dysfunction. It is well known that the main stimulus for proBNP synthesis and secretion from cardiac myocytes is myocyte stretch. Aims: Evaluation of the level of NT-proBNP in unrelated donors during the mobilization of HSC. Methods: We have examined 133 unrelated donors, including 92 men and 41 women, as part of a complex medical examination. The level of NT-proBNP was determined before the start of mobilization, then on the day of apheresis and after the donation of allogeneic HSC. The relationship of NT-proBNP levels with body mass index (BMI), ferritin, hemoglobin levels, leukocytosis on the day of apheresis was assessed. The median age of donors was 34 years (Q1-Q3). Mobilization of HSCs was managed with filgrastim administration at a dose of 10 μg/kg daily for 4-5 days. The first leukocytapheresis was performed on day 4 from the start of stimulation. Quantitative values of the blood serum NT-proBNP level are presented as a median (Me), first and third quartiles (Q1-Q3); correlation analysis was performed according to the Spearman method. Results: The initial blood serum NT-proBNP levels in all 133 donors were within the reference values: 21,6 (10,0; 43,3) pg/ml, while the level of NT-proBNP in women significantly exceeded that in men (Fig. 1). On the day of the first apheresis of HSC, a significant increase of blood serum NT-proBNP levels was detected – 131,2 (72,6; 165,3) pg/ml (p<0,001), higher rates were also noted in female donors (Fig. 2). A significant direct correlation was established between the level of NT-proBNP and the BMI of donors (correlation coefficient -0.18, p = 0,03), inverse - with the level of hemoglobin (correlation coefficient -0.33, p <0,001), ferritin (correlation coefficient-0.19, p = 0,03). No relationship has been established between the magnitude of leukocytosis achieved as a result of mobilization of HSC on the day of leukocytapheresis. A day after the apheresis, the blood serum NT-proBNP levels still exceeded the reference values, but there was a decreasing tendency. Unfortunately, further dynamic monitoring was not possible. Summary/Conclusion: An increase of the blood serum NT-proBNP level in unrelated donors during the mobilization of HSC was established. As a result, it is necessary to assess the impact of the identified changes of donors’ health status during further dynamic monitoring.Keywords: Allogeneic peripheral blood stem cells, G-CSF mobilization, Unrelated donor, Collection